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Prevention of Post-Stroke Generalized Anxiety Disorder, Using Escitalopram or Problem-Solving Therapy
Katsunaka Mikami, M.D., Ph.D.; Ricardo E. Jorge, M.D.; David J. Moser, Ph.D.; Stephan Arndt, Ph.D.; Mijin Jang, M.S.; Ana Solodkin, Ph.D.; Steven L. Small, Ph.D., M.D.; Pasquale Fonzetti, M.D.; Mark T. Hegel, Ph.D.; Robert G. Robinson, M.D.
The Journal of Neuropsychiatry and Clinical Neurosciences 2014;:. doi:10.1176/appi.neuropsych.11020047
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From the Dept. of Psychiatry, Carver College of Medicine, University of Iowa, IA (KM, REJ, DJM, SA, MJ, RGR); Depts. of Anatomy & Neurobiology, University of California-Irvine, Irvine, CA (AS); Dept. of Neurology, University of California-Irvine, Irvine, CA (SLS); Cornell University, Weill Medical College Memory Evaluation and Treatment Service (METS) at The Burke Rehabilitation Hospital, White Plains, NY (PF); Depts. of Psychiatry & Community and Family Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH (MTH); and Dept. of Psychiatry and Behavioral Science, Course of Specialized Clinical Science, Tokai University School of Medicine, Kanagawa 259-1193, Japan (KM).

Correspondence: Dr. Robinson; e-mail: robert-robinson@uiowa.edu

Copyright © 2014 by the American Psychiatric Association

Received February 22, 2011; Accepted September 23, 2013.

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This study examined the efficacy of antidepressant treatment for preventing the onset of generalized anxiety disorder (GAD) among patients with recent stroke. Of 799 patients assessed, 176 were randomized, and 149 patients without evidence of GAD at the initial visit were included in this double-blind treatment with escitalopram (N=47) or placebo (N=49) or non-blinded problem-solving therapy (PST; 12 total sessions; N=53). Participants given placebo over 12 months were 4.95 times more likely to develop GAD than patients given escitalopram and 4.00 times more likely to develop GAD than patients given PST. Although these results should be considered preliminary, the authors found that both escitalopram and PST were effective in preventing new onset of post-stroke GAD.

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